{"entity":{"id":"paper-quail-joyce-microenvironment-metastasis-natmed-2013","kind":"paper","name":"Quail and Joyce 2013: microenvironmental regulation of tumour progression and metastasis","aka":[],"tldr":"A review of how the normal cells around a tumour, including fibroblasts, immune cells and blood vessels, are recruited to help it grow and spread, and how distant organs are prepared to receive metastases before the cancer cells arrive.","summary":"Quail and Joyce surveyed the tumour microenvironment at each step of progression and metastasis: how cancer-associated fibroblasts, tumour-associated macrophages, other myeloid and lymphoid cells and the vasculature support primary tumour growth, invasion and intravasation; how bone marrow-derived cells and tumour-secreted factors establish a pre-metastatic niche in distant organs; and how the microenvironment at secondary sites governs dormancy and outgrowth. They discussed therapies aimed at these host cells, including macrophage-targeting and anti-angiogenic drugs, as complements to treatments aimed at the cancer cell.","asOf":"2026-09-08","links":[{"label":"Full text (DOI)","url":"https://doi.org/10.1038/nm.3394"}],"tags":[],"related":["paper-coussens-werb-inflammation-cancer-nature-2002"],"cancers":[],"sections":[],"technologies":["antiangiogenic"],"targets":["csf1r"],"drugs":[],"companies":[],"institutions":["mskcc"],"pathways":["metastatic-cascade","pre-metastatic-niche"],"terms":["metastasis","cancer-associated-fibroblasts","tumor-associated-macrophages","angiogenesis"],"trials":[],"people":["johanna-joyce"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"Nature Medicine","year":2013,"doi":"10.1038/nm.3394","authors":"Quail DF, Joyce JA.","paperType":"review","findings":["Stromal, immune and vascular cells are co-opted at every stage from primary growth to metastatic colonisation.","Tumour-derived factors and bone marrow-derived cells prepare pre-metastatic niches in distant organs before cancer cells arrive.","The microenvironment at secondary sites controls whether disseminated cells stay dormant or grow out."],"whatItMeans":"This review is the standard map of the tumour microenvironment and the reason microenvironment-directed drugs, from anti-angiogenics to macrophage and fibroblast targeting agents, are developed alongside tumour-cell-directed ones.","caveats":["A review; many mechanisms rest on mouse models.","Microenvironment-targeted therapies have had mixed clinical success so far."],"changedPractice":false},"route":"/key-papers/paper-quail-joyce-microenvironment-metastasis-natmed-2013/","neighbours":{"paper":[{"id":"paper-coussens-werb-inflammation-cancer-nature-2002","kind":"paper","name":"Coussens and Werb 2002: inflammation and cancer","route":"/key-papers/paper-coussens-werb-inflammation-cancer-nature-2002/"}],"technology":[{"id":"antiangiogenic","kind":"technology","name":"Anti-angiogenic therapy","route":"/technologies/antiangiogenic/"}],"target":[{"id":"csf1r","kind":"target","name":"CSF1R","route":"/targets/csf1r/"}],"institution":[{"id":"mskcc","kind":"institution","name":"Memorial Sloan Kettering Cancer Center","route":"/institutions/mskcc/"}],"pathway":[{"id":"metastatic-cascade","kind":"pathway","name":"The metastatic cascade","route":"/pathways/metastatic-cascade/"},{"id":"pre-metastatic-niche","kind":"pathway","name":"The pre-metastatic niche","route":"/pathways/pre-metastatic-niche/"},{"id":"tumor-microenvironment","kind":"pathway","name":"Tumour microenvironment (TME)","route":"/pathways/tumor-microenvironment/"}],"term":[{"id":"angiogenesis","kind":"term","name":"Angiogenesis","route":"/terms/angiogenesis/"},{"id":"cancer-associated-fibroblasts","kind":"term","name":"Cancer-associated fibroblasts (CAFs)","route":"/terms/cancer-associated-fibroblasts/"},{"id":"metastasis","kind":"term","name":"Metastasis","route":"/terms/metastasis/"},{"id":"microenvironment-inflammation-theory","kind":"term","name":"Microenvironment and inflammation: tumours as wounds that do not heal","route":"/terms/microenvironment-inflammation-theory/"},{"id":"tumor-associated-macrophages","kind":"term","name":"Tumour-associated macrophages (TAMs)","route":"/terms/tumor-associated-macrophages/"}],"person":[{"id":"johanna-joyce","kind":"person","name":"Johanna Joyce","route":"/people/johanna-joyce/"}]}}